Impact of Advanced Diabetes Centers on the healthcare experience of patients with type 2 diabetes using the IEXPAC tool

• Published in: Endocrinología, diabetes y nutrición. diabetes y nutrición., 2021-06, Vol.68 (6), p.416-427
• Main Authors: Gómez-García, Antón, Ferreira de Campos, Karine, Orozco-Beltrán, Domingo, Artola-Menéndez, Sara, Grahit-Vidosa, Viviana, Fierro-Alario, María José, Alonso-Jerez, Juan Luis, Villabrille-Arias, María Covadonga, Zuazagoitia-Nubla, José Félix, Ledesma-Rodríguez, Rocío, Fernández, Gonzalo
• Format: Article
• Language: English
• Subjects: Atención sanitaria; Chronic disease; Cross-Sectional Studies; Delivery of Health Care; Diabetes mellitus tipo 2; Diabetes Mellitus, Type 2 - drug therapy; Enfermedad crónica; Experience; Experiencia; Healthcare; Humans; Primary Health Care; Quality of Life; Surveys and Questionnaires; Type 2 diabetes
• ISSN: 2530-0180; 2530-0180
• DOI: 10.1016/j.endien.2021.10.003

To determine the experience with healthcare among patients with type 2 diabetes according to the assistance model provided in their primary care centers, and to determine factors related with their experience. This was a cross-sectional study performed in patients with type 2 diabetes with cardiovascular or renal complications. The patients were divided in two groups according to whether they had been attended in Advanced Diabetes centers (ADC) or the traditional assistance centers. Patient’s healthcare experience was assessed with the “Instrument for Evaluation of the Experience of Chronic Patients” (IEXPAC) questionnaire, with possible scores ranging from 0 (worst experience) to 10 (best experience). A total of 451 patients (215 from ADC and 236 from traditional assistance centers) were included. The mean overall IEXPAC scores were 5.9 ± 1.7 (ADC) and 6.0 ± 1.9 (traditional assistance centers; p = 0.82). In the multivariant analyses, in ADC, the regular follow-up by the same physician (p = 0.01) and follow-up by a nurse (p = 0.01), were associated with a better patient experience, whereas receiving a higher number of medications with a worse patient experience (p = 0.04). In the traditional assistance centers, only the regular follow-up by the same physician was associated with a better experience (p = 0.02). Patients from ADC centers reported a higher score in the quality of life scale (69.1 ± 16.5 vs 64.6 ± 17.5; p = 0.008). In general, the healthcare experience of type 2 diabetic patients with their sanitary assistance can be improved. Patients from ADC centers report a higher score in the quality of life scale. Determinar la experiencia con la atención sanitaria de pacientes con diabetes tipo 2 según el modelo asistencial ofrecido en su centro de atención primaria y determinar los factores relacionados. Estudio transversal, realizado en pacientes con diabetes tipo 2 y complicaciones cardiovasculares o renales. Los pacientes se dividieron en 2 grupos, en función de si fueron atendidos en Centros Avanzados de Diabetes (CAD) o siguiendo el modelo asistencial tradicional. La experiencia del paciente con la atención sanitaria se determinó mediante el cuestionario IEXPAC (Instrumento de Evaluación de la Experiencia del Paciente Crónico), donde 0 representa la peor experiencia y 10 la mejor. Se incluyeron 451 pacientes (215 en centros con el modelo asistencial tradicional y 236 con el modelo CAD). Las puntuaciones medias del cuestionario IEXPAC fueron 5,9 ±